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Clin Nurse Spec. 2011 Jul-Aug;25(4):180-5. doi: 10.1097/NUR.0b013e318221f2aa.

Improving sepsis outcomes for acutely ill adults using interdisciplinary order sets.

Author information

1
Ochsner Medical Center, 1514 Jefferson Hwy., New Orleans, LA, USA. fwinterbottom@ochsner.org

Abstract

PURPOSE/OBJECTIVE:

The objective of the study was to measure outcomes following implementation of standardized order sets for managing patients with severe sepsis/septic shock.

BACKGROUND/RATIONALE:

Sepsis is a severe illness, affecting approximately 750 000 people in the United States, with mortality rates of 28% to 50%, and costing $17 billion each year.

PROJECT DESCRIPTION:

An interdisciplinary team was created to improve early recognition and process of care in patients with severe sepsis/septic shock. Education was rolled out over 6 months, and sepsis "bundle" order sets were implemented.

SETTING AND SAMPLE:

Adult patients (N = 674) with a diagnosis of severe sepsis or septic shock who were admitted to an emergency department or critical care unit at a 563-bed tertiary care teaching facility from May 2008 through October 2010 were included in data analysis.

METHODS:

A plan, do, study, act methodology was used. Outcomes following project implementation were measured prospectively including appropriate recognition of patients with a diagnosis of sepsis, hospital site where the order set was initiated, and attainment of treatment goals within 6 hours of onset of severe sepsis/septic shock.

FINDINGS:

When order set usage was analyzed, the use of order sets was significantly associated with meeting "6-hour goals" successfully (χ1 [n = 662] = 36.16, P < .001); order set usage explained 24% of the variation in meeting goals, R = 0.24, F1,661 = 38.51, P < .0001.

CONCLUSIONS:

Order sets improved management of septic patients through effective change in delivery systems to support evidence-based medical care.

IMPLICATIONS FOR PRACTICE:

Administrative support, team collaboration, and standardized order sets can lead to improved process of care.

PMID:
21654373
DOI:
10.1097/NUR.0b013e318221f2aa
[Indexed for MEDLINE]

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